Five-Question Interview with Meg Jones-Monteiro of the Interfaith Center on Corporate Responsibility

1. What do you consider to be ICCR's most important work related to healthcare?

As faith-based investors, we advocate for corporate and systemic reforms that will improve access and affordability of health care for all, especially for those persons who are most vulnerable. We believe corporations have an important role to play in not only in responding to the health care disparities in our country, but also in ensuring that the quality of care provided is equitable across populations. In other words, if the root cause of the disparity is preventable and is the direct result of a social injustice, then we see that as a problem.

For decades, ICCR members have pressed drug companies for greater disclosures on pricing structures as a way to promote greater access to medicines. A lack of transparency around how drug prices are determined has led to an industry-wide ethos of “whatever the market will bear”, which can lead to predatory pricing. We have asked companies to disclose the rates of price increases year-to-year of their top selling branded prescriptions drugs and to disclose the rationale and criteria used for these price increases. We have also asked the companies to assess the legislative, reputational, and financial risks these increases represent for the companies. However, that lack of transparency still prevails.   

Most recently, we have become increasingly concerned about pharmaceutical companies’ governance structures and their Boards’ ability to proactively mitigate risk related to high drug prices.  In other words, are executives incentivized to simply increase the price of drugs with no added benefit in clinical efficacy simply to meet short term revenue targets?  In particular, we are seeking better articulation of the goal-setting process and the translation of those goals into incentive pay targets.

As investors, our members firmly believe that the pharmaceutical industry plays a vital role in ensuring healthy and productive societies ­­- be it the prevention or treatment of some of the most debilitating diseases.  Yet, we see the reliance on increasing drug prices as a primary generator of revenue/or growth strategy as an unsustainable business practice.  The current convergence of increasing public concern and political commitment to address this issue presents grave reputational, financial, and regulatory risks to the industry.

2. What motivates you to do your work on healthcare?

Aligned with the Article 25 of the U.N. Universal Declaration on Human Rights human rights, our members believe that “Everyone has the right to a standard of living adequate for the health and well-being of ‘themselves and their family’, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond ‘their’ control.”  Without health, what do you have?

3. What are the biggest challenges you—or those you represent—face?

The rising cost of medicine and cost of health care broadly is deeply concerning.  We have all been sick at one point in our lives and must recognize the importance of having a supportive, accessible and affordable health care system. Yet when 1 in 4 adults say that they or a family member has a not filled a prescription, cut pills in half, or skipped a dose because of cost, we know that that our system is not designed to meet the needs of the patient, but rather the system itself.  One salient challenge we face is that the pharmaceutical industry is steadfast in the protection of their industry, and instead of owning their contribution to restricted access to medicine, they are quick to assign blame to the other actors in the system.

4. What do you think the U.S. healthcare system should look like?

People living in the US should have access to affordable equitable healthcare.  That means that the job you hold, the zip code in which you live, the amount of money you make should not determine whether you live or die. There should be shared responsibility across all of the actors in the healthcare system in ensuring that all Americans have equitable access to quality healthcare.  As such, we call upon the companies we hold, investor organizations, faith-based communities, health care systems, and all our allies to share in the responsibility of providing affordable health care for all Americans.  This requires a re-envisioning the current incentive structure that fails to put the patient at the center.

5. What role do you see people of faith and faith communities playing in making the needed changes?

As faith and values-based investors, ICCR members have a long-standing history of engagement with pharmaceutical companies. Our assumptions include: (1) leveraging shareholders rights to influence companies’ business practice will help us to move towards our goal of improving access; (2) companies will listen and act on investors’ call to move away from achieving short-term returns and towards sustainable business strategies that advance the common good; (3) collaborating with NGO stakeholders and the media further helps investors leverage their influence to foster company change; and (4) collectively these actions contribute to the long-term goal of improving access and quality of medicines, if stakeholders stay committed to this goal. In order to successfully implement these practices, the companies should be willing to listen, consider and incorporate the views of investors in their business practice. 

The voice of the faith-based investors can sometimes make the case that other mainstream investors cannot.